POS1534-HPR WRIST JOINT POSITION SENSE AND MANUAL DEXTERITY IN CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS
Authors: G. Duran, D. Bayraktar, A. C. Kalkan, S. Turkucar, B. Makay, E. Unsal, A. Genc
Journal: Annals of the Rheumatic Diseases (2022)

Background Joint position sense is a marker of proprioception and is defined as being aware of the body position and individual body parts in the space. Position sense in the wrist joint is especially important for the manual dexterity. A possible damage due to arthritis may lead a decrease in joint position sense. However, the status of joint position sense was not investigated in children with juvenile idiopathic arthritis (JIA). Objectives To compare the wrist position sense and a motor performance test related to manual dexterity among children with JIA with wrist arthritis history (JIAWrist+), children with JIA without wrist arthritis history (JIAWrist-), and healthy controls. Methods A total of sixty children (20 children for each group) were included in the study. Wrist joint position sense was evaluated by measuring joint re-position error. The wrist was passively placed in a pre-determined position (30 o for flexion, 30 o for extension, 10 o for radial deviation, and 15 o for ulnar deviation). Then passively was returned to baseline position. The patient was asked to reposition their wrist into the target degree actively. The absolute error in degrees between each position and reposition was calculated. Manual dexterity was evaluated by using Purdue Pegboard Test. The test was repeated three times and the average number of the correctly placed pines was used in the analysis. Results Joint position sense (in all directions except radial deviation) and manual dexterity (except assembly) was found negatively affected in JIAWrist+ patients compared to healthy controls. No differences (except radial deviation) were observed between JIAWrist- patients and healthy controls. Table 1. Comparison of the groups JIAWrist+ (n:20) JIAWrist- (n:20) Healthy Controls (n:20) Physical Characteristics Median (IQR 25/75) Median (IQR 25/75) Median (IQR 25/75) p* Age (years) 14.0 (10.5/16.0) 12.5 (11.0/14.5) 12.0 (10.0/13.0) 0.131 Body-Mass Index (kg/m 2 ) 20.1 (18.8/22.6) 18.9 (15.7/23.9) 18.6 (16.8/21.9) 0.477 Disease Related Data Median (IQR 25/75) Median (IQR 25/75) Median (IQR 25/75) p** Disease Duration (months) 27.5 (10.5/64.0) 31.5 (11.0/63.0) NA 0.903 Gender n (%) n (%) n (%) p*** Female 19 (95%) 10 (50%) 13 (65%) 0.007 Male 1 (5%) 10 (50%) 7 (35%) Joint Re-position Error Median (IQR 25/75) Median (IQR 25/75) Median (IQR 25/75) p* Flexion ( o ) 5.2 (3.3/6.7) 2.7 (2.0/4.0) 2.0 (1.3/2,7) p&lt;0.001 p1: 0.061 p2&lt; 0.001 p3: 0.148 Extension ( o ) 3.8 (2.2/6.0) 3.5 (2.8/4.5) 1.8 (1.3/4.0) p: 0.038 p1: 1.000 p2: 0.045 p3: 0.171 Radial Deviation ( o ) 2.8 (2.0/5.2) 3.3 (1.8/4.7) 2.0 (1.3/2.7) p: 0.022 p1: 1.000 p2: 0.051 p3: 0.048 Ulnar Deviation ( o ) 3.5 (2.5/4.3) 2.3 (1.5/3.0) 1.7 (1.2/2.7) p: 0.003 p1: 0.084 p2: 0.003 p3: 0.805 Flexion ( o ) 5.2 (3.3/6.7) 2.7 (2.0/4.0) 2.0 (1.3/2,7) p&lt;0.001 p1: 0.061 p2&lt; 0.001 p3: 0.148 Manual Dexterity Median (IQR 25/75) Median (IQR 25/75) Median (IQR 25/75) p* Purdue Pegboard Test Single Hand (score) 15.2 (13.5/15.5) 15.2 (14.5/16.2) 16.2 (15.0/18.0) p: 0.022 p1: 0.981 p2: 0.019 p3: 0.244 Purdue Pegboard Test Both Hands (score) 11.0 (9.8/12.0) 11.0 (10.3/12.3) 12.5 (11.7/13.2) p: 0.006 p1: 1.000 p2: 0.007 p3: 0.051 Purdue Pegboard Test Assembly (score) 26.5 (23.0/28.5) 26.0 (23.5/29.0) 28.0 (25.5/30.0) p: 0.243 *Kruskal-Wallis Analysis, **Mann-Whitney-U Test, ***Chi-Square Test, p&lt;0.05. JIAWrist+: children with JIA with wrist arthritis history; JIAWrist-: children with JIA without wrist arthritis history, NA: not applicable, p1: JIAWrist+ vs. JIAWrist-; p2: JIAWrist+ vs. healthy controls; p3: JIAWrist- vs. healthy controls. Conclusion Joint position sense and related manual dexterity is diminished in JIA patients with wrist involvement. The results of this study suggested that children with wrist arthritis should be followed with special attention focusing on manual abilities. Hand therapy programs might help improving joint position sense acuity. Disclosure of Interests None declared